Infective Endocarditis with Cerebral Infarction in a Hemodialysis Patient with Failed Renal Allograft

Korean Journal of Nephrology 2011;30(5):551-556.

Hee Jae Jung, M.D.1, Byung Chul You, M.D.1, Yu Sik Myung, M.D.1, Eun Jung Kim, M.D.1, Moo Yong Park, M.D.1, Soo Jeong Choi, M.D.1, Jin Kuk Kim, M.D.1, Seung Duk Hwang, M.D.1, Eun Suk Koh, M.D.2 and Keun Her, M.D.3

Department of Internal Medicine¹
Pathology2 and Thoracic Surgery³
Soonchunhyang University, College of Medicine, Bucheon, Korea

증례 : 이식 후 신기능 상실로 혈액투석을 시작한 환자에서 뇌경색을 동반한 감염성 심내막염 1예

정희재1, 유병철1, 명유식1, 김은정1, 박무용1, 최수정1, 김진국1, 황승덕1, 고은석2, 허균3

순천향대학교 의과대학 내과학교실1 , 병리학교실2 , 흉부외과학교실3

Abstract

Infective endocarditis is a dreaded complication in dialysis or kidney transplantation patients, with high morbidity and mortality. Despite the improved early survival of the transplanted kidney with new immunosuppressive agents, the number of patients returning to dialysis after a failed renal allograft is increasing. There is no consensus on the optimal management of immunosuppression in patients with a failed allograft. Continued immunosuppression is associated with infection, and the rapid discontinuation of immunosuppression may lead to acute rejection. Therefore, it is important to taper the immunosuppression properly in patients with a failed renal allograft. We report on a hemodialysis patient with a failed renal allograft who had a cerebral infarction following infective endocarditis. The patient was treated successfully with antibiotics and valve replacement.

Key Words: Kidney transplantation, Hemodialysis, Endocarditis, Cerebral infarction